• 第二軍醫(yī)大學(xué)長(zhǎng)海醫(yī)院胸心外科,上海 200433;

目的  分析膨體聚四氟乙烯( Gore-Tex) 補(bǔ)片在胸壁重建中的注意事項(xiàng),總結(jié)臨床應(yīng)用經(jīng)驗(yàn)。方法  回顧性分析第二軍醫(yī)大學(xué)長(zhǎng)海醫(yī)院 2001年 1月至 2010年 l2月期間 33例使用 Gore-Tex補(bǔ)片進(jìn)行修復(fù)巨大胸壁缺損的臨床資料,男 19例,女 14例;平均年齡 45.7(20~73)歲。根據(jù)腫瘤位置、大小選擇不同的手術(shù)切口;術(shù)中盡量保留正常的胸壁軟組織,骨性胸壁缺損采用 Gore-Tex補(bǔ)片進(jìn)行重建,軟組織直接對(duì)攏縫合,全層胸壁缺損采用轉(zhuǎn)移肌皮瓣覆蓋創(chuàng)面。結(jié)果  全組 33例均手術(shù)順利,圍術(shù)期無(wú)死亡患者;惡性腫瘤 25例,良性腫瘤 8例,均被完整切除,切除瘤體直徑 8~20 cm。隨訪 5~60個(gè)月,失訪 3例(9.09%),無(wú)排斥反應(yīng)及反常呼吸,無(wú)異物感,感染率 3%(1/33)。結(jié)論  Gore-Tex補(bǔ)片具有極佳的生物相容性,是安全有效的胸壁重建材料;選擇合適的肌皮瓣覆蓋補(bǔ)片,能夠減少并發(fā)癥發(fā)生。

引用本文: 李春光,陳和忠,李志剛等. 膨體聚四氟乙烯補(bǔ)片在胸壁重建中的應(yīng)用. 中國(guó)胸心血管外科臨床雜志, 2012, 19(3): 248-250. doi: 復(fù)制

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1.  茅乃權(quán), 左傳田, 周元明, 等. 胸壁腫瘤的外科治療. 中國(guó)胸心血管外科臨床雜志, 2005, 12 (4):299-300..
2.  Tan PW, Wong CH, Koong HN, et al. Chest wall reconstruction using a combined musculocutaneous anterolateral-anteromedial thigh flap. Indian J Plast Surg, 2010, 43 (1):88-91.
3.  Daliakopoulos SI, Klimatsidas MN, Korfer R. Solitary metastatic adenocarcinoma of the sternum treated by total sternectomy and chest wall reconstruction using a Gore-Tex patch and myocutaneous flap:a case report. J Med Case Reports,2010, 1 (4):75.
4.  Schoenmaeckers EJ, van der Valk SB, van den Hout HW, et al. Computed tomographic measurements of mesh shrinkage after laparoscopic ventral incisional hernia repair with an expanded polytetrafluoroethylene mesh. Surg Endosc, 2009, 23 (7):1620-1623.
5.  Gonfiotti A, Santini PF, Campanacci D, et al. Malignant primary chest-wall tumours:techniques of reconstruction and survival. Eur J Cardiothorac Surg, 2010, 38 (1):39-45.
6.  Incarbone M,Pastorino U. Surgical treatment of chest wall tumors. World J Surg, 2001, 25 (2):218-230.
7.  Bosc R, Lepage C, Hamou C, et al. Management of chest wall reconstruction after resection for cancer: a retrospective study of 22 consecutive patients. Ann Plast Surg, 2011, 67 (3), 263-268.
8.  Deschamps C, Tirnaksiz BM, Darbandi R, et al.Early and long-term results of prosthetic chest wall reconstruction.J Thorac Cardiovasc Surg,1999, 117(3):588-591.
9.  李東, 李健寧, 牛星燾, 等. 膨體聚四氟乙烯在整形外科的應(yīng)用. 中華整形外科雜志, 200l, 17 (1):43-45.
10.  Hamad AM, Marulli G, Bulf R, et al. Titanium plates support for chest wall reconstruction with Gore-Tex dual mesh after sternochondral resection. Eur J Cardiothorac Surg, 2009, 36 (4):779-780.
11.  Danino A, Saito S, Mamlouk K, et al. Complete chest wall reconstruction after en bloc excisions with Gore-Tex/Marlex/Flap sandwich. A retrospective study of 14 cases. Ann Chir Plast Esthet, 2003, 48 (2):86-92.
12.  Gapany C, Raffoul W, Zambelli PY, et al. Latissimus dorsi muscle-flap over Gore-Tex patch for coverage of large thoracic defects in paediatric Ewing sarcoma. Pediatr Blood Cancer,2009, 52 (5):679-681.
13.  D’Alessandro P, Carey-Smith R, Wood D. Large resection and reconstruction of primary parietal thoracic sarcoma: a multidisciplinary approach on 11 patients at minimum 2-years follow-up. Orthop Traumatol Surg Res, 2011, 97 (1):73-78.
14.  Sunil I, Bond SJ, Nagaraj HS. Primitive neuroectodermal tumor of the sternum in a child: resection and reconstruction. J Pediatr Surg ,2006, 41 (11):e5-e8.
15.  Hyans P, Moore JH Jr, Sinha L. Reconstruction of the chest wall with e-PTFE following major resection. Ann Plast Surg, 1992, 29 (4):321-327.
16.  王昆, 孫玉鶚. Gore-Tex修復(fù)大塊胸壁缺損8例. 中華胸心血管外科雜志, 2001, 17(1):49.
17.  Saiki M, Urata Y, Hamasaki T, et al. Mediastinal abdominal wall fistula due to ePTFE membrane. Kyobu Geka, 2008, 61 (2):135-137.
18.  Nagayasu T, Yamasaki N, Tagawa T. Long-term results of chest wall reconstruction with DualMesh. Interact Cardiovasc Thorac Surg, 2010, 11 (5):581-584.
  1. 1.  茅乃權(quán), 左傳田, 周元明, 等. 胸壁腫瘤的外科治療. 中國(guó)胸心血管外科臨床雜志, 2005, 12 (4):299-300..
  2. 2.  Tan PW, Wong CH, Koong HN, et al. Chest wall reconstruction using a combined musculocutaneous anterolateral-anteromedial thigh flap. Indian J Plast Surg, 2010, 43 (1):88-91.
  3. 3.  Daliakopoulos SI, Klimatsidas MN, Korfer R. Solitary metastatic adenocarcinoma of the sternum treated by total sternectomy and chest wall reconstruction using a Gore-Tex patch and myocutaneous flap:a case report. J Med Case Reports,2010, 1 (4):75.
  4. 4.  Schoenmaeckers EJ, van der Valk SB, van den Hout HW, et al. Computed tomographic measurements of mesh shrinkage after laparoscopic ventral incisional hernia repair with an expanded polytetrafluoroethylene mesh. Surg Endosc, 2009, 23 (7):1620-1623.
  5. 5.  Gonfiotti A, Santini PF, Campanacci D, et al. Malignant primary chest-wall tumours:techniques of reconstruction and survival. Eur J Cardiothorac Surg, 2010, 38 (1):39-45.
  6. 6.  Incarbone M,Pastorino U. Surgical treatment of chest wall tumors. World J Surg, 2001, 25 (2):218-230.
  7. 7.  Bosc R, Lepage C, Hamou C, et al. Management of chest wall reconstruction after resection for cancer: a retrospective study of 22 consecutive patients. Ann Plast Surg, 2011, 67 (3), 263-268.
  8. 8.  Deschamps C, Tirnaksiz BM, Darbandi R, et al.Early and long-term results of prosthetic chest wall reconstruction.J Thorac Cardiovasc Surg,1999, 117(3):588-591.
  9. 9.  李東, 李健寧, 牛星燾, 等. 膨體聚四氟乙烯在整形外科的應(yīng)用. 中華整形外科雜志, 200l, 17 (1):43-45.
  10. 10.  Hamad AM, Marulli G, Bulf R, et al. Titanium plates support for chest wall reconstruction with Gore-Tex dual mesh after sternochondral resection. Eur J Cardiothorac Surg, 2009, 36 (4):779-780.
  11. 11.  Danino A, Saito S, Mamlouk K, et al. Complete chest wall reconstruction after en bloc excisions with Gore-Tex/Marlex/Flap sandwich. A retrospective study of 14 cases. Ann Chir Plast Esthet, 2003, 48 (2):86-92.
  12. 12.  Gapany C, Raffoul W, Zambelli PY, et al. Latissimus dorsi muscle-flap over Gore-Tex patch for coverage of large thoracic defects in paediatric Ewing sarcoma. Pediatr Blood Cancer,2009, 52 (5):679-681.
  13. 13.  D’Alessandro P, Carey-Smith R, Wood D. Large resection and reconstruction of primary parietal thoracic sarcoma: a multidisciplinary approach on 11 patients at minimum 2-years follow-up. Orthop Traumatol Surg Res, 2011, 97 (1):73-78.
  14. 14.  Sunil I, Bond SJ, Nagaraj HS. Primitive neuroectodermal tumor of the sternum in a child: resection and reconstruction. J Pediatr Surg ,2006, 41 (11):e5-e8.
  15. 15.  Hyans P, Moore JH Jr, Sinha L. Reconstruction of the chest wall with e-PTFE following major resection. Ann Plast Surg, 1992, 29 (4):321-327.
  16. 16.  王昆, 孫玉鶚. Gore-Tex修復(fù)大塊胸壁缺損8例. 中華胸心血管外科雜志, 2001, 17(1):49.
  17. 17.  Saiki M, Urata Y, Hamasaki T, et al. Mediastinal abdominal wall fistula due to ePTFE membrane. Kyobu Geka, 2008, 61 (2):135-137.
  18. 18.  Nagayasu T, Yamasaki N, Tagawa T. Long-term results of chest wall reconstruction with DualMesh. Interact Cardiovasc Thorac Surg, 2010, 11 (5):581-584.